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Hypnosis: Clinical and Stage

by Edward Bruce Bynum, Ph.D., A.B.P.P., Director of Behavioral Medicine
Mental Health Department, University Health Services


     What is hypnosis? This question has intrigued researchers, clinicians and just about everyone else for millennia. Hypnosis clearly involves some phenomena of trance, a change in concentration, and some absorption. In fact, this triad of trance, concentration, and psychological absorption in inner states has come to be understood as the hallmarks of the hypnotic phenomena. Hypnosis does not occur however only in a clinician's office. Hypnosis can occur in more spontaneous situations. When you go to a theater, or watch a very engrossing movie, you are very absorbed in the phenomenon. During those times when you are so absorbed in what's going on in the movie or the other performance that you forget that you are actually watching something, that is a form of hypnosis.
     Hypnosis is similar to meditation, relaxation and visualization, however there are some very crucial differences. Hypnosis involves the absorption and concentration of the mind in a "trance state", using imagery to enhance the experience. Relaxation and visualization involve concentration and absorption but not necessarily a trance state. In relaxation and visualization one is very aware of external phenomena. In hypnosis one is psychologically absorbed so much in internal mental , visual and emotional phenomena that their awareness of external phenomena outside of the body is significantly decreased. Meditation, on the other hand, is quite different from either relaxation and visualization or hypnosis. Authentic meditation across various methodilogies involves the disciplined focus of the mind in such a way that eventually the contents of mind themselves are transcended and the dynamics of consciousness that are nonverbal and non-visual emerge. In other words, hypnosis, relaxation and visualization use the contents of the mind to change the mind. The purpose of meditation is to get beyond the mind itself to dimensions and dynamics of consciousness without an object.
     Hypnosis is also similar to dreams and what is called "reverie". However, hypnosis usually occurs during the waking state and one can go into a state of hypnosis and learn to influence the process of dreams. Dreams on the other hand, occur when one is sleeping, not when one is awake and are associated with coordinated rapid eye movement (REM) and other distinct psychological phenomena. Reverie is that state in between in which one is very engaged in visualization usually associated with a pleasant situation. However, reverie is neither a dream state that occurs completely in the unconscious, nor is it a complete trance state in which hypnosis is involved. These are along the same continuum clearly but obviously have discreet and localized unique areas.
     When one goes to a clinical psychologist for the use of hypnosis, it is usually for a very specific symptom oriented situation. This requires a certain degree of professional training because powerful phenomena of the unconscious mind and emotionality are involved. When one goes to see a hypnotist who is doing "stage hypnosis" , this can be very entertaining and fun. However, it is not without certain risks. The stage hypnotist accepts no responsibility for the dynamics of the patient, nor are there any legal sanctions involved. This is not the case with the person trained in clinical hypnosis who is also a licensed practitioner. Also the stage hypnotist is appropriately more interested in entertainment and not necessarily uncovering and clinical work. There may be some similarities in their techniques, however, a stage hypnotist uses the phenomenon of the group and other "demand characteristics" to induce hypnotic like phenomena. The clinical psychologist using hypnosis in therapy is usually working in a one-to-one context and has taken an extensive history of the person's dynamics, life context and the specific issues with which they are struggling.
     The history of the clinical use of hypnosis actually goes back thousands of years. The ancient Kemetic Egyptians were the first to write about the clinical use of hypnosis. Thousands of years later this was picked up in the Greco-Roman era. The Egyptians called their "sleep temples" Per Ankh. These were both houses, libraries and places of study and at the same time often therapeutic sites. During the medieval times in Europe, various colorful characters traveled around using a form of hypnosis. Eventually, hypnosis became an interest of the medical and psychological practitioners of Europe. Eventually subtle and complicated theories of hypnosis began to rule the day.
     It is in many ways the last century in which hypnosis as we see it today in clinical practice began. The techniques of abreaction and pain control for other phenomena were known and indeed written about in the ancient world. However, it was the last century in Europe that these became clearly entrenched in medical practice in the modern era.
     Today hypnosis in used widely in a clinical context. It is used in psychotherapy for the exploration of trauma. It is very similar but not identical to the current practice of EMDR for trauma work. EMDR or eye movement desensitization and reprocessing is a specialized technique for trauma victims using eye movement and memory reorganization to change the patient's emotional inner landscape and "digest" painful experiences. Various other hypnotic techniques such as age regression, pain control, dream analysis, and emotional restructuring are all commonly used in hypnosis.
     During the actual phenomena or experience of hypnosis, various kinds of experiences spontaneously occur. Often in hypnosis the phenomena of emotional and psychological regression occurs. So does the phenomena of dissociation, alteration of sensory experiences, increasingly vivid imagery, and potential relearning responses to various conditions as in EMDR. Hypnosis in a therapeutic context can be perceived and directed along many paths depending upon the clinician's orientation. In the phenomena of age regression, a phenomena in which one "goes back to an earlier time" psychologically and explores that area, the actual perception of the event typically takes one of two forms. There is either a re-integration of the situation in which one is observing the phenomena from a distance, or is what can be called re-vivification. This is the actual direct reliving or re-experiencing of a prior situation. Both are powerful and a skilled clinician assesses the patient before entering into this phase. Thus, hypnosis has many different uses and one needs to be mindful of the use of hypnosis in order to gain the greatest benefit.
     There are certainly times when seeking out a hypnotherapist are very useful. However, whenever seeking out a hypnotherapist for a clinical reason, one must be sure that the hypnotherapist is appropriately trained. Many people can go and take a weekend course in hypnosis but not have any clinical background. This is a dangerous situation to put oneself in. One needs to seek out a professional in an area who has specialized training in hypnosis for the maximum benefit.
     Hypnosis can be used as an adjunct or part of an overall therapeutic regimen. This is indeed the way most clinicians use hypnosis. Hypnosis can also be very usefully employed for specific problems, such as smoking cessation, weight control, and negative habit formation. However again, there are certain potentially negative effects of hypnosis. One again must make sure that one is not seeking a stage hypnotist or someone not qualified to bring ones own personal problems to. This is because during the phenomena of hypnosis, the patient may experience a sudden eruption of past traumatic situations. If the person is not trained clinically, this can be quite a problem. There are also important legal issues surrounding memory recovering that vary from state to state. In some states memories recovered under hypnosis are not useful or are actually illegal in a court of law. The clinically trained hypnotist is aware of these legal issues. Finally, hypnotherapy and actually hypnoanalysis are very specialized forms of treatment that may last a considerable period of time. Again one needs to be aware of why one is seeking out hypnosis and indeed if hypnosis is the best treatment of choice. Hypnosis has a long and honorable history in medical science dating back from the earliest ancient Egyptian medical times on down to the present. It is very likely therefore that some form of hypnosis will be used by our species as we travel the stars and planets in the future.

References

Professional Societies:

The International Association for Clinical and Experimental Hypnosis

American Association of Clinical Hypnotists

Books:

Margaret Brennan, Ph.D., and Merton M. Gill, MD, 1971 Hypnotherapy , International University Press, New York

Rothlyn P. Zahourek, 1990 Clinical Hypnosis and Therapeutic Suggestion in Patient Care, Brunner/Mazel, Inc., New York, NY

Milton H. Erickson, MD, 1976 Hypnotic Realities: The Induction of Clinical Hypnosis and Forms of Indirect Suggestion, Irvington Publishers, Inc., New York

Andre M. Weitzenhoffer, 1963 Hypnotism: An Objective Study in Suggestibility, John Wiley and Sons, Inc., New York

Shapiro, F. 1995 Eye Movement Desensitization and Reprocessing, Guilford Press, N.Y.


© 2000 Obelisk Foundation, Inc.